The objective of this proposal is to prepare a manual for the use of HSAs in order to assist their staffs in preparing and their Boards of Directors, Council members and various committee members in judging cost-effectiveness analyses particularly in the areas of health promotion. The manual will summarize and simplify the current "state of the art" in preparing cost-effectiveness and cost-benefit studies. It would include a decision theory approach and also contain appropriate caveats and warnings as to the limitations of cost-benefit analysis. In addition, the manual will contain a number of useful cost-benefit analyses in the areas of prevention and community medicine. The work plan is to distill and translate the technical literature and review the applied studies. There will be an emphasis on costs calculation and benefits calculation complexities. Topics will include: operating program vs experimental program costs: discounting for present value purposes; value of death postponed; applications for planning. The manual will summarize the current state of cost-effectiveness analyses in regard to inpatient alternatives, long term care of the aged, programs for special groups, primary and secondary prevention programs for cancers and cardiovascular diseases. Other areas to be covered include; ambulatory surgery, maternity centers (out of hospital), rubella vaccination, home care, home renal dialysis, hypertension control (particularly at work site), risk factor reduction (life-style change), and screening for early detection of breast, colon, and cervix cancers.